Computerized Nutrition Screening and Clinical Nutrition Management System Increases Clinical Productivity

Abstract

LEARNING OUTCOME: To describe an automated, comprehensive, team-oriented approach to clinical nutrition productivity management and nutrition screeningDirect clinical nutrition services are provided at three separate campuses by three departments. This results in a fragmented, inconsistent approach toward clinical nutrition care for patients. A Performance Improvement team, consisting of dietitians, pharmacists, and nurses, was established to address this issue. The team worked hand-in-hand with the Information Services Department to develop a comprehensive, automated, nutrition screening and clinical productivity management system utilizing the hospital patient information system. The system, implemented in May 1995, features a nutrition screening component which generates nutrition screening reports for all patients directly on the patient care units. It also allows for scheduling of re-screening, initial assessments and re-assessments (follow-ups) by each department providing care. This scheduling information provides the data necessary to create a daily “Nutrition Visitation Report” indicating the clinical duties due and which care provider is responsible for the patient as of that day by nursing units. This report is utilized daily by the clinicians to prioritize their work assignments. The system also generates an audit report which lists past due clinical assignments. This report is utilized by the Clinical Nutrition Manager to identity and trend productivity problems. The system has resulted in an increase in clinical productivity of~40-50%. The largest increase has been experienced in the number of initial assessments and re-assessments completed by the Clinical Nutrition Staff. Additionally, the automated system prevents patients from “falling through the cracks” by providing a mechanism for transferring care from unit to unit and service to service. Most remarkably, these results were realized with a minimal outlay of capital expenditure since the system was designed using the in-house patient information system and in-house system designers and coders. Maintenance on the system is minimal since there is no interface to maintain. Numerous program enhancements are in development to insure the system continues to meet the nutrition needs of the hospital in the future.